ArticleNeurocritical care2021
Temporal Dynamics of ICP, CPP, PRx, and CPPopt in High-Grade Aneurysmal Subarachnoid Hemorrhage and the Relation to Clinical Outcome.
Article in Neurocritical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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Who cites it
42 citing papers in PubMed, 56 citations in OpenAlex.
- Invasive Monitoring of Cerebral Autoregulation in Aneurysmal Subarachnoid and Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- A Case Report on Cerebral Autoregulation in Posterior Reversible Encephalopathy Syndrome After Aneurysmal Subarachnoid Hemorrhage.Critical care explorations · 2026Article
- Haemorrhage, hypercoagulability and ischaemia: Evolution of brain injury after aneurysmal subarachnoid haemorrhage.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Review
- Temporal dynamics of ICP, PRx, CPP, and CPPopt in relation to functional outcome in spontaneous cerebellar hemorrhage.Critical care (London, England) · 2026Article
- Multi-center pressure reactivity index temporal trajectories for predicting outcome in comatose subarachnoid hemorrhage patients.Neurosurgical review · 2026Article
- Cerebral autoregulation in the hyperacute phase after experimental subarachnoid haemorrhage using an endovascular perforation model.Brain communications · 2026Article
- Impact of intracranial pressure and related parameters on prognosis in patients undergoing surgery for ruptured intracranial aneurysms.Neurosurgical review · 2025Article
- Prognosis of subarachnoid hemorrhage determined by intracranial pressure thresholds.Journal of cerebrovascular and endovascular neurosurgery · 2025Article
- Article
- The metabolic and autoregulatory profile of reversible delayed cerebral ischemia in unconscious patients after aneurysmal subarachnoid hemorrhage: a prospective multimodal neuromonitoring cohort study.Critical care (London, England) · 2025Article
- Decompressive craniectomy in aneurysmal subarachnoid hemorrhage: can favorable outcome be achieved?Acta neurochirurgica · 2025Article
- Revisiting the oxygen reactivity index in traumatic brain injury: the complementary value of combined focal and global autoregulation monitoring.Critical care (London, England) · 2025Article
- Individualized autoregulation-guided arterial blood pressure management in neurocritical care.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Optimal cerebral perfusion pressure during induced hypertension and its impact on delayed cerebral infarction and functional outcome after subarachnoid hemorrhage.Scientific reports · 2024Observational
- Individualized Autoregulation-Derived Cerebral Perfusion Targets in Aneurysmal Subarachnoid Hemorrhage: A New Therapeutic Avenue?Journal of intensive care medicine · 2024Observational
- The Optimal pressure reactivity index range is disease-specific: A comparison between aneurysmal subarachnoid hemorrhage and traumatic brain injury.Journal of clinical monitoring and computing · 2024Observational
- Correlation between early intracranial pressure and cerebral perfusion pressure with 28-day intensive care unit mortality in patients with hemorrhagic stroke.European stroke journal · 2024Article
- Cerebral autoregulation, spreading depolarization, and implications for targeted therapy in brain injury and ischemia.Reviews in the neurosciences · 2024Review
- Interaction of Optimal Cerebral Perfusion Pressure with Early Brain Injury and its Impact on Ischemic Complications and Outcome Following Aneurysmal Subarachnoid Hemorrhage.Neurocritical care · 2024Observational
- Clinical Outcome of Patients with Poor-Grade Aneurysmal Subarachnoid Hemorrhage with Bundled Treatments: A Propensity Score-Matched Analysis.Neurocritical care · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) may induce secondary brain injury following aneurysmal subarachnoid hemorrhage (aSAH). In the current study, we aimed to determine the temporal incidence of insults above/below certain ICP/CPP thresholds, the role of pressure autoregulation in CPP management (PRx and CPPopt), and the relation to clinical outcome.
methodsIn this retrospective study, 242 patients were included with aSAH, who were treated in the neurointensive care unit, Uppsala University Hospital, Sweden, 2008-2018, with ICP monitoring the first 10 days post-ictus. Data from ICP, pressure autoregulation (PRx), CPP, and CPPopt (the CPP with the lowest/optimal PRx) were analyzed the first 10 days. The percentage of good monitoring time (GMT) above/below various ICP and CPP thresholds was calculated, e.g., ICP > 20 mm Hg (%), CPP < 60 mm Hg (%), and ∆CPPopt (CPP-CPPopt) < - 10 mm Hg (%).
resultsOf the 242 patients, 63 (26%) had favorable (GOS-E 5-8) and 179 (74%) had unfavorable (GOS-E 1-4) outcome at 12 months. Higher proportion (GMT) of ICP insults above 20 mm Hg was most common the first 3 days post-ictus and was then independently associated with unfavorable outcome. CPP gradually increased throughout the 10 days post-ictus, and higher proportion of GMT with CPP < 90 mm Hg was independently associated with unfavorable outcome in the late vasospasm phase (days 6.5-10). PRx was above 0 throughout the 10 days and deteriorated in the late vasospasm phase. Higher values were then independently associated with unfavorable outcome. There was no difference in GMT of CPP deviations from CPPopt between the outcome groups.
conclusionsAvoiding intracranial hypertension early and maintaining a high CPP in the vasospasm phase when the pressure autoregulation is most disturbed may improve clinical outcome after aSAH.
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